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Multicenter case series of indolent small/medium-sized CD8+ lymphoid proliferations with predilection for the ear and

Janet Y Li1, Joan Guitart, Melissa P Pulitzer

  • 1*Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY; †Department of Dermatology, Northwestern University, Chicago, IL; ‡Department of Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY; §Department of Dermatology and Pathology, Yale University, New Haven, CT; Departments of ¶Pathology, and ‖Dermatology, Stanford University, Stanford, CA; and **Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY.

The American Journal of Dermatopathology
|January 8, 2014
PubMed

Insights

This study describes a rare CD8 lymphoid proliferation affecting the ear and face. These indolent T-cell growths show a favorable prognosis, highlighting the need for precise diagnosis to prevent over-treatment.

Area of Science:

  • Dermatopathology
  • Immunohistochemistry
  • Oncology

Background:

  • CD8 lymphoid proliferations can present with varied clinical behaviors.
  • Distinguishing indolent from aggressive lymphoid neoplasms is crucial for patient management.

Purpose of the Study:

  • To characterize the clinical and histopathologic features of a specific CD8 lymphoid proliferation.
  • To evaluate the clinical course and treatment outcomes of affected patients.

Main Methods:

  • Retrospective case series of 7 patients with ear and face lymphoid lesions.
  • Histopathological examination including immunohistochemistry (CD3, CD8, β-F1, TIA-1, CD4, CD30, CD56).
  • Assessment of proliferation index and clinical staging for extracutaneous disease.

Main Results:

  • All 7 patients presented with stable, asymptomatic lesions on the ear, nose, or lower eyelid.
  • Histopathology revealed atypical lymphocytes with a cytotoxic T-cell phenotype (CD8+, CD4-, CD30-, CD56-) and a low proliferation index (10%-15%).
  • No patients showed evidence of extracutaneous disease, and all remained in complete remission at a median follow-up of 14 months.

Conclusions:

  • This CD8 lymphoid proliferation exhibits an indolent clinical course and a distinct histopathologic phenotype.
  • Accurate diagnosis, supported by immunohistochemistry and proliferation index, is essential to guide appropriate management and avoid overtreatment.
  • The favorable prognosis underscores the importance of conservative therapeutic approaches for this condition.

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